Lens and Glaucoma by Joel S. Schuman, MD FACS, Viki Christopoulos, MD, Deepinder

By Joel S. Schuman, MD FACS, Viki Christopoulos, MD, Deepinder K. Dhaliwal, MD, Malik Y. Kahook, MD, and Robert J. Noecker, MD MBA (Auth.)

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1 A white cortical cataract secondary to atopic skin disease. B C D Inflammatory Cataract A Fig. 2 (A) A shield-like anterior subcapsular cataract in another atopic patient with a history of longstanding topical steroid use. (B) Close-up of (A). (C) The patient’s left eye also had a visually significant anterior subcapsular cataract. (D) Close-up of (C). 49 Inflammatory Cataract (Continued) B SECTION 5 • Cataract A Fig. 3 (A) This 48-year-old woman treated her severe, longstanding dermatitis with chronic, intermittent use of topical steroid creams.

1 A white cortical cataract secondary to atopic skin disease. B C D Inflammatory Cataract A Fig. 2 (A) A shield-like anterior subcapsular cataract in another atopic patient with a history of longstanding topical steroid use. (B) Close-up of (A). (C) The patient’s left eye also had a visually significant anterior subcapsular cataract. (D) Close-up of (C). 49 Inflammatory Cataract (Continued) B SECTION 5 • Cataract A Fig. 3 (A) This 48-year-old woman treated her severe, longstanding dermatitis with chronic, intermittent use of topical steroid creams.

4 A metallic foreign body lodged within the lens of a 30-year-old man (eye photographed at initial injury). The affected area soon became a cataract. Fig. 3 Retroillumination of the eye shown in Fig. 2 highlights the localized inferior cortical cataract caused by the intralenticular iron foreign body. Fig. 6 Traumatic cataract resulting from a BB gun injury. 39 Radiation-induced Cataract Key Facts SECTION 4 • Trauma • The lens is the most radiosensitive ocular structure • Most susceptible if less than 1 year of age • Radiation damages tumor DNA as well as cell membranes, causing germinative lens epithelial cells to swell, migrate posteriorly, and form posterior polar subcapsular cataract in 22–87% of eyes • Stationary or progressive • Latency period: months to years • Four stages: 1.

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